Biomedical subjects

K Takai

Publications and source records attributed to K Takai.

At least 199 records · Page 11Linked to original sources

PubMed1991

Chronic lymphocytic leukemia associated with von Recklinghausen neurofibromatosis.

We report a 62-year-old female, with von Recklinghausen neurofibromatosis and chronic lymphocytic leukemia, whose mother and son both had neurofibromatosis and died of digestive tract cancers. The patient died of pneumonia 3 years after the initiation of therapy. Leukemia reported in association with neurofibromatosis are predominantly nonlymphocytic and limited to childhood. The type of association found in our patient has not been reported previously.

Female↗

PubMed1990

Effects of FK506 on rat thymus: time-course analysis by immunoperoxidase technique and flow cytofluorometry.

The effect of administration of FK506 at 1 mg/kg body weight for 14 days on rat lymphoid tissues, especially the thymus, and recovery after discontinuation of treatment, were investigated by the immunoperoxidase technique and flow cytofluorometry using monoclonal antibodies OX6, OX7, OX8, OX18 and W3/25, reactive with rat lymphocytes. Marked reduction of the thymic medulla upon treatment was clearly demonstrated by staining with OX18 and OX6. Changes produced by FK506 were also observed in the cortical area of the thymus, and were especially marked in the subcapsular area and around blood vessels. Eventually, the thymic cortex appeared patchy, this change being maximal 14 days after the start of administration. Obvious restitution of the thymic medulla was evident about 14 days after withdrawal of FK506. Flow cytometric analysis of the thymus showed that the percentages of cells labelled positively with OX7, OX8 and W3/25 were increased with FK506 treatment, and recovered to the normal level soon after withdrawal. Furthermore, the peak of fluorescence intensity of OX7+, OX8+ and W3/25+ cells showed a temporary shift to the right during FK506 treatment; however, the peak of fluorescence intensity of OX18+ cells showed a temporary shift to the left. Treatment with FK506 also produced a significant change in 3H-thymidine uptake by thymocyte. These results suggest that FK506 may inhibit the proliferation, maturation and differentiation of thymocytes. However, thymocytes prepared from FK506-treated rats and labelled with FITC behaved similarly to rat thymocytes in normal recipient rats. This suggests that during FK506 treatment thymocytes may retain their potential for peripheral mobilization.

Animals↗

PubMed1990

Effect of pregnancy on the disposition of valproate in rats.

The disposition of sodium valproate in pregnant rats was studied comparing with nonpregnant (control) rats. In the pregnant rats, the total plasma clearance decreased significantly (p less than 0.05) from 7.06 ml/min/kg of the control to 5.34 ml/min/kg, whereas the plasma elimination half-life of valproate did not change. The serum unbound fraction (fs) of pregnant rats increased remarkably. The fs of the fetal plasma was lower than that of the maternal serum in spite of the lower albumin (main binding protein for valproate) concentration in the fetal plasma. A non-linear serum (plasma) protein binding was observed both in the control and the fetal rats, but not observed in the pregnant rats. In the pregnant rats, the tissue-to-plasma concentration ratio (Kp) of the brain was higher than that in the control rats, whereas the Kp values of the liver and and lung were lower than those in the control rats. In other tissues, the Kp values did not show a significant difference. Rapid placental transfer was observed and the Kp value of the fetus was 0.43.

Animals↗

PubMed1990

The role of alpha 1- and alpha 2-adrenoceptors in canine systemic capacitance vessels--a study with measurement of mean circulatory pressure.

We investigated the presence of alpha-adrenoceptor subtypes in systemic capacitance vessels by examining the effects of alpha 1- and alpha 2-agonists or antagonists on the mean circulatory pressure (MCP). Dogs were anesthetized with pentobarbital, and after total spinal anesthesia, epinephrine was given intravenously to maintain mean blood pressure at about 80 mmHg. 1. With intravenous injection of phenylephrine (alpha 1-agonist, 10 micrograms/kg, n = 7), and of BHT 920 (alpha 2-agonist, 5 micrograms/kg, n = 7), MCP increased significantly from 9.8 +/- 0.4 (mean +/- SE) to 10.9 +/- 0.3 mmHg (+11.2%, p less than 0.01), and from 9.3 +/- 0.4 to 10.3 +/- 0.4 mmHg (+10.8%, p less than 0.05), respectively. 2. Intravenous injection of prazosin (alpha 1-antagonist, 150 micrograms/kg, n = 7) and of yohimbine (alpha 2-antagonist, 30 micrograms/kg, n = 7) decreased MCP significantly from 9.9 +/- 0.4 to 8.2 +/- 0.5 mmHg (-17.2%, p less than 0.01), and from 9.8 +/- 0.2 to 7.6 +/- 0.3 mmHg (-22.4%, p less than 0.01), respectively. 3. Intravenous injection of phenylephrine (10 micrograms/kg, n = 7) after pretreatment with prazosin (150 micrograms/kg) decreased MCP significantly from 9.5 +/- 0.3 to 7.8 +/- 0.3 mmHg (-17.9%, p less than 0.01). MCP decreased significantly from 9.9 +/- 0.3 to 8.2 +/- 0.3 mmHg (-17.2%, p less than 0.01) after intravenous injection of BHT 920 (5 micrograms/kg, n = 7) following pretreatment with yohimbine (30 micrograms/kg).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Agonists↗

PubMed1990

Surgical treatment of metastatic renal cell carcinoma.

The survivals of 174 patients who underwent nephrectomy for renal cell carcinoma were analyzed to evaluate the influence of the surgical treatment of metastases on their prognosis. For 34 of the 174 patients, surgical resections of the metastases were performed concurrently with nephrectomy. For 38 patients, 44 surgical resections of metastases were performed in the follow-up period after nephrectomy. Apparently curative resections of metastases, at the time of nephrectomy or after nephrectomy, were significantly correlated with good survivals after surgery, irrespective of the number of metastatic foci. Aggressive surgical treatment was beneficial in patients with a longer tumor-free period after nephrectomy or with stable disease for about six months after surgical treatment, although this might simply be a reflection of a longer natural disease course in this specific group of patients.

Adult↗

PubMed1990

Nonregressing lipodystrophia centrifugalis abdominalis with angioblastoma (Nakagawa).

We describe a case of lipodystrophia centrifugalis abdominalis lasting until 46 years of age. Recently, angioblastoma (Nakagawa), which contained large numbers of mast cells, developed in the same region. A case of lipodystrophia centrifugalis abdominalis with an infant-onset that lasted until adulthood has not been reported. This is the first report of lipodystrophia centrifugalis abdominalis that lasted until adulthood.

Female↗

PubMed1990

[A case of condyloma accuminatum around the anus in a married man].

A 34-year-old man was admitted to our hospital with warts around the anus persisting for the past four months as the chief complaint. There was no history of anal intercourse. All laboratory examinations of syphilis, hepatitis, chlamydia trachomatis, acquired immunodeficiency syndrome and other sexually transmitted diseases (STD) were negative. After application of amantadine, the warts disappeared completely in about two weeks. With diversification of sexual encounters, such a case of anal warts as a type of STD may increase in the domain of urology as well.

Adult↗

PubMed1989

Differential vasodilator effect of nitroglycerin on systemic capacitance and resistance vessels in anesthetized dogs, and the mechanism of its action--a study by measuring mean circulatory pressure and total peripheral resistance.

The aim of our studies was to examine if the baroreceptor reflex induced by intravenous injection of nitroglycerin (NG) nearly nullifies the vasodilator action of NG on the systemic capacitance vessels in dogs anesthetized with pentobarbital. We performed total spinal anesthesia (TSA) in open-chest dogs to eliminate the baroreceptor reflex. Dogs in which mean blood pressure (MBP) was maintained at about 100 mmHg by continuous intravenous infusion of epinephrine formed the TSA 100 group, and those in which MBP was maintained at about 70 mmHg formed the TSA 70 group. Dose-response curves relating 5-6 different doses (0.8 to 200 micrograms/kg) of intravenous NG, to changes in mean circulatory pressure (% delta MCP) and to changes in total peripheral resistance (% delta TPR), were constructed. These data were compared with those from untreated dogs. In addition, we also studied plasma catecholamine (CA) concentrations before and after the intravenous injection of NG. (1) There was no significant difference in the dose-response curves of NG for % delta TPR between the 3 groups. (2) There was no significant difference in the dose-response curves for % delta MCP between the 2 TSA groups. However, there was significant difference in the dose-response curves for % delta MCP between the TSA groups and the untreated dogs. The dose-response curves for % delta MCP in the TSA groups shifted upwards as compared with that of the untreated dogs. (3) In the TSA 100 group, there was no significant increase in the plasma CA concentrations with 100 micrograms/kg of NG. In the untreated group, intravenous injection of 12.5 micrograms/kg and 100 micrograms/kg of NG caused a dose-related fall in MBP and a dose-related rise in the plasma norepinephrine and epinephrine concentrations. Our results suggest that the vasodilator action of NG on the systemic capacitance vessels in the untreated dogs was counterbalanced partly by the vasoconstriction produced by the baroreceptor reflex, with its direct vasodilator effect masked when the hypotensive doses of NG were given acutely.

Anesthesia, Spinal↗

PubMed1989

[Stage IV renal cell carcinoma producing alpha-fetoprotein treated with multimodal treatment. A case report].

A 63 year old man, having right renal cell carcinoma which was found after initial symptoms of left supraclavicular tumor and gross hematuria, is presented. The points to note with this case are; (1) An unusual production of alpha-fetoprotein (AFP), (2) Being discovered at a very advanced stage and that the disease progressed rapidly (at initial presentation the patient had lymph nodes metastases from the paraaorta, mediastinum to the left supraclavicular region. Later the patient had a recurrent tumor in the left supraclavicular area and multiple cutaneous metastases), (3) Various modalities of treatment were given (right nephrectomy, abdominal lymph nodes dissection, resection of the supraclavicular and mediastinal lymph nodes metastases, hyperthermia combined with irradiation for the recurrent tumor in the supraclavicular region and systemically adoptive immunotherapy with tumor infiltrating lymphocytes). During this treatment course, the drift of serum AFP showed a good correlation. The possibility of AFP as a tumor marker of renal cell carcinoma in selected cases was presented and the suitability of the treatments performed to this patient was discussed.

Carcinoma, Renal Cell↗

PubMed1989

[A case of proliferative chronic cystitis, progressing to obstructive nephropathy, treated by total cystectomy and enterocystoplasty].

A 52 year-old man, being pointed out as with microscopic hematuria and suspected of carcinoma of the urinary bladder at another institution, visited this hospital for further examination. DIP demonstrated an irregular right lateral wall of the urinary bladder. CT of the pelvic cavity revealed a protrusive mass lesion inside the urinary bladder. Cystoscopy proved a circular, edematous and irregular mass lesion around the urinary bladder neck. The pathological examination of TUR specimens showed a proliferative chronic cystitis. However, after about half a year, there was a recurrence of mass lesions in the urinary bladder. Moreover, right non-functional kidney and left hydronephrosis were observed. For preserving renal function, total cystoprostatectomy was performed. Nerve sparing technique for sexual function, and total bladder replacement using a detubularized sigmoid colon to obviate the need for a stoma were adopted. Postoperative course was uneventful and the function of both kidneys was recovered. Normal urination from the urethra and sexual function are both preserved. Pathological examination of the cystectomized specimen confirmed only proliferative cystitis with extensive deep ulceration and thick connective tissues. A rare case in which obstructive nephropathy was caused by proliferative cystitis is reported and discussed.

Chronic Disease↗

PubMed1989

[Analysis of renal cell carcinoma with tumorous legion in the liver].

We presented 3 cases of renal cell carcinoma with hepatic lesion, for which it was difficult to make a diagnosis preoperatively. The hepatic lesion was cavernous hemangioma of the liver, liver metastasis of renal cell carcinoma or hepatocellular carcinoma. To discuss the strategy of treatment for liver metastasis of renal cell carcinoma at the time of nephrectomy, or in the follow-up period after nephrectomy, we reviewed the 188 cases of renal cell carcinoma which were nephrectomized from December, 1962 to June, 1988. At the time of nephrectomy, there was only 1 case that had concurrent liver metastasis. In 4 cases, liver metastasis was found at autopsy, and in 15 cases, in the follow-up period after nephrectomy. We analysed these 15 cases and classified them into 2 groups. One was "early metastasis group", i.e., liver metastasis was found within 18 months after nephrectomy, and the other was "late metastasis group", i.e., liver metastasis detected more than 6 years after nephrectomy. In the "early metastasis group", 2 lived 10 months or 57 months, but 5 died within 1 month after the appearance of liver metastasis. In the "late metastasis group", 4 of 7 lived more than 2 years after the appearance of liver metastasis and the median survival was 21 months. In both groups, when liver metastasis was found, there were metastases in multiple organs and the hepatic lesions were multiple.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1989

[Bladder replacement by enterocystoplasty after total cystectomy].

From May 1987 to April 1988, 7 male patients, 43-69 years old in age, underwent enterocystoplasty after total cystectomy. In 5 of them, a selected intestinal segment, consisted of the terminal portion of the ileum, the cecum and the proximal part of the ascending colon, was freed and detubularized for construction of "bladder" substitution. In the remaining two patients with a previous history of cholecystectomy, having severe intestinal adhesions, the ileum or the sigmoid-colon were used. At 3 months after operation, 6 patients had a vesical capacity of 300 ml or more and the maximum volume of urine excreted at one voiding was 200 ml or more. Daytime continence had been achieved in 6 patients at 3 months after operation, whereas nighttime continence had been achieved in 5 patients at 6 months after operation. Serum electrolytes, pH value of arterial blood and renal function, were all normal during the follow-up period (5-13 months). Potency was preserved in 2 patients. All the patients, except one whose "bladder" was constructed with ileum and who was performing daily intermittent selfcatheterization, were able to enjoy almost the same activity of daily life as before operation. The final shape of the "bladder" and its position in the pelvic space seemed to be an important factor for the "bladder" function after operation. By our hand, however, postoperative cystogram revealed a sigmoid shape in all cases, though the reservoirs had an oval shape at the time when they had been constructed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

[Cultivation of human tumor infiltrating lymphocytes for use in adoptive immunotherapy].

We have developed a method of in vitro stimulation of TIL and PBL using immobilized anti CD3 antibody instead of autologous tumors. After this treatment, proliferation of T cells was greatly enhanced. Separated TILs were cultured by OKT3 coated 96 well culture plate for about one week with 10% human serum and 1,000U/ml of rIL-2 supplemented RPMI-1640 medium, and then transferred to plain vessels. TIL increased in number by more than 5,000-fold after 3 weeks. PBLs obtained from 10 ml of peripheral blood were cultured in OKT3-coated culture flask (75 cm2) with 10 ml of medium for about one week, and then in plain flasks and finally expanded by culture in gas-permeable culture bags. PBL proliferated by more than 1,000-fold after 2 weeks. TIL or PBL cultured by this method contained over 90% activated T cells positive for the Leu4 marker, and HLA-DR. About 60% of these were CD8-positive and about 40% were CD4-positive. Only a small number of Leu 11-positive cells were detected in every case.

Antibodies↗

PubMed1989

[Fechtner syndrome: report of two families and review of the literature on the related disorders].

Two families who had been reported as having May-Hegglin anomaly were diagnosed as having Fechtner syndrome based on complication of renal disease, deafness and characteristic leukocyte inclusions. By Wright-Giemsa staining, the inclusions of neutrophils were smaller and stained less clearly than those seen in May-Hegglin anomaly. Ultrastructurally, the inclusions consisted of organelle-poor cytoplasm, containing small particles, which were probably ribosomes. Some inclusions contained only a few filaments or small remnants of rough endoplasmic reticulum (RER). The latter resembled the findings observed in Fechtner syndrome. They lacked the parallel arrays of filaments characteristic of May-Hegglin anomaly and the parallel strands of RER seen in toxic Döhle bodies. Renal disorders ranged from microscopic hematuria to renal failure requiring dialysis in one family and persistent proteinuria in the other family. Deafness was sensorineural type or combined type due to otitis media. Except for the fact that they lacked congenital cataracta, the findings in these two families were consistent with those in Fechtner syndrome.

Adult↗

PubMed1989

[Peripheral T-cell lymphoma initially presenting as secondary myelofibrosis].

A case of peripheral T-cell lymphoma presenting with secondary myelofibrosis and meningeal involvement is described. A 65-year-old female was admitted because of remarkable weight loss and pancytopenia. On admission, she was confused and showed tiny cervical lymph nodes but no hepatosplenomegaly. Bone marrow aspiration resulted in dry tap and its biopsy showed remarkable myelofibrosis with marked decrease of hematopoiesis and increase of lymphoid cells. Lymph node biopsy revealed diffuse medium sized cell lymphoma, which was diagnosed as CD3+4+8-peripheral T-cell lymphoma with immunohistochemistry (anti-HTLV-1 antibody negative). The lymphoid cells of bone marrow expressed the markers of T-cell lineage (LCA+ UCHL1+ MT1+ L26- MB1-). The cerebrospinal fluid examination revealed many lymphoma cells. She was treated with CHOP regimen and intrathecal injection of MTX. After three months, bone marrow biopsy showed recovery of hematopoiesis and disappearance of lymphoma cells and reticulin fibers. Immunohistochemical analysis of bone marrow specimen was useful for the diagnosis of atypical myelofibrosis.

Aged↗

PubMed1989

Prognosis in renal cell carcinoma: analysis of clinical course following nephrectomy.

The clinical courses and survivals of 159 patients who underwent nephrectomy for renal cell carcinoma are reviewed. A longer disease-free period after nephrectomy was correlated with significantly better survival. Among patients in whom metastases in the lungs or bones were detected after nephrectomy, those with between one and five pulmonary or solitary bone metastases, without definite increases in their number and size in the six months following their first appearance, survived significantly longer than patients with a similar number of metastases but which did increase in number and size in the following six months, or patients with six or more pulmonary or multiple bone metastases. Even when metastases detected after nephrectomy were confined to the lungs or bones throughout the observation period, the patients did not necessarily show significantly better survivals than patients with metastases detected in multiple sites.

Adult↗

PubMed1989

Total replacement of the bladder with an intestinal pouch for normal micturition after cystectomy.

Between May 1987 and April 1988, seven male patients aged 43-69 years underwent an operation for total replacement of the bladder with an intestinal pouch for normal micturition after cystectomy. In five, the detubularized ileocecocolic segment was used as the internal reservoir and, in the other two, the ileum or the sigmoid colon was used because of a severe adhesion of the ascending colon due to previous surgery. Three months after surgery, six patients had a vesical capacity of 300 ml or more and could excrete a maximum 200-300 ml urine at one voiding. Daytime continence was achieved in six patients in three months, and night-time continence in five patients in six months. No abnormalities in serum electrolytes, acid-base balance or renal function were observed during follow-up periods of 8-16 months. The patients were enthusiastic about this procedure, including the patient requiring occasional self-catheterization to overcome his incontinence. The follow-up periods have been short, but this method seems promising as a new internal diversion.

Aged↗

PubMed1988

Relationship between papillary and nodular transitional cell carcinoma in the human urinary bladder.

A total of 186 cystectomized specimens were examined by step-sectioning to determine the relation between papillary and nodular transitional cell carcinomas of the urinary bladder. Tumors were classified as papillary (PC), nodular (NC), and carcinoma in situ (CIS) according to their gross and microscopic configurations. These cases, grouped as simple combinations of PC, NC, and CIS, namely, PC, PC + CIS, PC + NC, PC + NC + CIS, NC, NC + CIS, and CIS, were analyzed with respect to (a) the time from the initial symptom to cystectomy, (b) the treatment before cystectomy, (c) the grade, (d) the stage of tumors, (e) the multiplicity of tumors, (f) the presence of papillary structures inside or on the surface of nodular carcinoma, and (g) data on survival after cystectomy. Of the tumors, 17 were classified as CIS and 80 as PC and PC + CIS. Studies on 57 cases suggested an early change from PC to a mixture of PC and NC through papillonodular carcinoma during development, whereas 6 showed late development of NC during repeated recurrence of PC. These courses indicate that some cases of NC developed from PC. On the other hand, 26 cases exhibited direct progression from CIS to NC. Thus nodular invasive carcinomas may develop in two ways: by emergence of a more anaplastic cell population within a preexisting low grade papillary carcinoma; and by de novo development of an invasive nodular carcinoma directly from CIS.

Adult↗